3 kilometers from the dream: the medical mystery behind the runner's death

Rachel Affa, a 24-year-old former college athlete from Pennsylvania, collapsed during the New York Marathon just three kilometers from the finish line and died. Her father stated that the medical suspicion is a rare condition called rhabdomyolysis. Experts explain the medical mechanism, risk factors, and statistics on mortality in races.

Rachel Affa, a 24-year-old former college athlete from Pennsylvania, collapsed during the New York Marathon this week just three kilometers from the finish line and died after resuscitation efforts. Her father stated that the medical suspicion is rhabdomyolysis, a rare condition in which skeletal muscle cells break down rapidly due to extreme exertion, releasing substances into the bloodstream that can cause kidney damage, arrhythmias, and system collapse. Dr. Jonathan Kim, director of the Sports Cardiology Center at Emory University, explains that death from rhabdomyolysis in a marathon is extremely rare, and that the common cause of sudden cardiac arrest is a heart attack. Dr. Doug Farrell, a nephrology specialist at Mount Sinai Hospital, notes that heat and humidity can worsen the condition, and cites a 2022 study in which 24 runners with rhabdomyolysis were treated at the New York Marathon under extreme heat conditions, compared to 3-4 in a normal year. The article highlights the difficulty of identifying the syndrome due to its symptoms resembling ordinary fatigue, and notes encouraging data on the reduced risk of death from sudden cardiac arrest in races thanks to the deployment of defibrillators.